The Neurology of Calm Gayatri Devi, MD Clinical Associate Professor of Neurology New York University School of Medicine President National Council on Women’s Health President-Elect American Medical Women’s Association

The Neurology of Calm Overview Modern Deterrents to Calm The Anatomy of Calm The War of the Brains (Top vs Bottom) Vagal Tone and Calm Parenting and Calm Gender Alarms: Body Image in Girls Getting to Calm/ Practical Suggestions

Modern Deterrents to Calm Urban environments Information / Forgetting Multi-tasking Sleep Choices Digital Interaction Constant Availability Role of Women Lives of Children

Frontal lobe in skull

The brain in the skull

The Neuroscience of Anxiety/Fear

The Calm of Children Choices Scheduling Fear Parenting Powerful Children The Gifted Child – Story of Elena

The Calm of Children Jerome Kagan 43 children Age 21 months, videotaped shyness, behavioral inhibition & vagal tone Two years later, 22 confident kids as confident, 21 anxious kids more anxious 104 two year-olds and parenting style Children more irritable & fearful (low vagal tone) had more anxious moms

Children at School

ADHD & environmental factors 267 families, low socioeconomic status Followed from 6m - 42 m Child and maternal variables rated 34 hyperactive kids, 34 controls (24 boys/gp) Correlates of ADHD in kindergarten: 2/3 maternal variables – Overstimulation- advanced play (42 months) – Maternal interference- (6 months) 1/30 child variables – late motor maturation

Brain Changes in Anxiety Infants of depressed mothers-low vagal tone Massage, music in adolescent mothers/ infants Increased right frontal activation with depression Present even when behavior ceases Neurological and physiological change Every change/ experience/ memory associated with changes in brain connections Girls’ education and teacher strategies

Girls, Body Image and the Media

Adolescent Girls: Body Image

The Neuroscience of Body Image Univ. of London study- 111 boys and 124 girls – ages 16-18, in school – mean body wgt of girls 57 kgs (125 lbs) – mean body wgt of boys 69 kgs (152 lbs) EAT, self esteem, reason for exercise, contour drawing surveys completed. Furnham et al, J Psychol 2002

The Neuroscience of Body Image

80% of girls AND boys dissatisfied with their weight. However, nearly as many boys wished to be heavier (36%) as thinner (43%) Only 9 girls wished to be heavier; 75% chose an ideal figure thinner than theirs Girls/women exercise to lose weight, boys/men not necessarily.

The Neuroscience of Body Image Face recognition vs body recognition Right frontal cortex, insula and cingulate gyrus main regions in self recognition. Posterior sensory areas versus more anterior (evolved, neocortex) association areas.

The Neuroscience of Body Image Self versus other images 10 AN women, 10 normal controls. Difference: no activation of the insula and the attentional areas of brain when viewing self Prior study showed activation of amygdala in AN patients Role of the amygdala and insular cortex AN suppress emotional & perceptual processing

The Neuroscience of Body Image

13 men and 13 women left amygdala activated only in women left prefrontal cortex and hippocampus activated only in men Shirao et al, 2005

The Neuroscience of Body Image

1998 metanalysis of 222 studies over 50 years Feingold & Mazella, 1998 Pre-1970, 70s, 80s, 90s Ages 12-14, 14-16, 16-18, 18-23, 23-35, >35 N= 37,627 Results: – body satisfaction: men vs women – Men vs women, self assesment on looks “The analysis shows dramatic increases in the numbers of women among individuals who have poor body image. Moreover, these trends were found across multiple conceptualizations of body image, including self-judgments of physical attractiveness.”

The Neuroscience of Body Image

The plastic brain Shaped by experiences and memories The phantom limb syndrome Change the brain, control the eating disorder Change the brain, change society

“I am the Change” Film Festival The National Council on Women’s Health’s – Screenings in NYC schools – Panel, Screening, Small Group Discussion – Short Film Competition School Wide Competition City Wide Competition – WE are the Change!

Getting To Calm Disconnect from The Cell Phone Sleep without alarms and sleeping aid Parent without too many choices Promote relationships and face to face contact Engage the vagus!! Take breaks from multitasking Upcoming book on Calm

The Neurology of Calm AMAZON.COM Available June 2012